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Insulin dependent diabetes in children under 5: incidence and ascertainment validation for 1992
E Wadsworth1, J Shield, L Hunt
1Institute of Child Health, Bristol.
Insights
The incidence of insulin-dependent diabetes in young children in the British Isles remained stable between 1988 and 1992. Comprehensive case ascertainment for pediatric diabetes requires multiple reporting sources.
Area of Science:
- Pediatric Endocrinology
- Epidemiology
- Public Health
Background:
- Childhood diabetes, specifically insulin-dependent diabetes (IDDM), is a significant health concern.
- Previous studies have monitored the incidence of IDDM in pediatric populations.
- Understanding trends in childhood diabetes incidence is crucial for resource allocation and public health planning.
Purpose of the Study:
- To determine the incidence of new-onset insulin-dependent diabetes in children under 5 years old in the British Isles in 1992.
- To compare these findings with a 1988 national study.
- To assess the completeness of case ascertainment in the 1992 study.
Main Methods:
- Utilized the British Paediatric Surveillance Unit for active monthly reporting by consultant pediatricians.
- Supplemented data with reports from specialist diabetes nurses and regional health authorities.
- Included all children diagnosed with primary insulin-dependent diabetes under age 5 and residing in the British Isles during 1992.
Main Results:
- A total of 387 children were diagnosed with insulin-dependent diabetes, yielding a national incidence of 9.3 per 100,000 children per year.
- This incidence rate is comparable to the 9.9 per 100,000 children per year reported in 1988.
- Capture-recapture analysis indicated an overall ascertainment rate of 99% when aggregating three data sources in specific regions.
Conclusions:
- The national incidence of insulin-dependent diabetes in children under 5 in the British Isles showed no significant change between 1988 and 1992.
- Achieving near-complete case ascertainment (99%) necessitated the use of multiple, comprehensive data sources.
- The study underscores the importance of employing multiple data streams for robust epidemiological surveillance of childhood diabetes.
Objective:
To establish the incidence of insulin dependent diabetes diagnosed in children under 5 years of age in the British Isles during 1992, comparing the national and regional results with those of our 1988 national study, and estimating the 1992 study's level of case ascertainment.
Design:
Active monthly reporting of cases by consultant paediatricians through the framework of the British Paediatric Surveillance Unit, with additional reports from specialist diabetes nurses and regional health authorities.
Subjects:
All children diagnosed under the age of 5 years with primary insulin dependent diabetes from 1 January to 31 December 1992 (inclusive) and resident in the British Isles at diagnosis.
Results:
387 children (208 boys and 179 girls) were confirmed to have insulin dependent diabetes, giving a national incidence of 9.3/100,000/year. This is similar to the 9.9/100,000/year found in 1988. Three sample capture-recapture analysis, which could only be applied across the 12 (out of 18) regions supplying regional information to the study, suggested ascertainment rates of 78% for the British Paediatric Surveillance Unit, 67% for specialist nurses, 69% for regional health authorities, and 99% for the aggregated registry.
Conclusions:
The national incidence of diabetes in the under 5s in the British Isles did not differ between 1988 and 1992. Nearly complete (99%) ascertainment of cases was possible only for regions for which three data sources were available. Capture-recapture analysis highlighted both the need for more than one data source and for each data source to be complete for the whole study area.